How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $891.25 Median $1,548.82 Typical High $8,709.64 | Facility | None | $891.25 | $1,548.82 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $1,096.48 Typical High $1,096.48 | Professional | None | $812.83 | $1,096.48 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,467.37 Typical High $4,897.79 | Facility | None | $602.56 | $3,467.37 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,023.29 Typical High $1,479.11 | Professional | None | $851.14 | $1,023.29 | $1,479.11 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $245.47 Typical High $1,230.27 | Professional | None | $33.11 | $245.47 | $1,230.27 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $2,238.72 Typical High $5,128.61 | Facility | None | $602.56 | $2,238.72 | $5,128.61 |
Providence Setting Professional Modifier None Typical Low $851.14 Median $1,023.29 Typical High $1,621.81 | Professional | None | $851.14 | $1,023.29 | $1,621.81 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $4,786.30 Typical High $12,882.50 | Facility | None | $1,348.96 | $4,786.30 | $12,882.50 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,230.27 Typical High $1,584.89 | Professional | None | $776.25 | $1,230.27 | $1,584.89 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $407.38 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $407.38 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $162.18 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $616.60 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $123.03 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $81.28 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $575.44 | $776.25 | $776.25 |
Where New Mexico sits
The same service costs 20.9 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
New Mexico· 26th of 51
$1,202
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.